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Tuesday, May 02, 2017

Fibromyalgia

People with chronic pain describe a variety of patterns -generalized aching associated with tender "pressure points" are common complaints. Fibromyalgia sufferers often say:" I feel like I am 90 years old." Stiffness after sitting or lying down is common. The stiffness and pain will often improve with mild activities, but overly vigorous exertion makes it worse. There are many ideas about Fibromyalgia. Patients are often frustrated and confused. Physicians are not always helpful and insurance companies are reluctant to pay disability claims. Some people have strong opinions and beliefs about Fibromyalgia and some support groups champion one idea over all others.The Problem

Generalized pain and stiffness

Associated fatigue, digestive disturbances, cognitive dysfunction and many other symptoms

The Solution

Complete, comprehensive diet revision, using the Alpha Nutrition Program

Physical therapy, exercise

We believe that Fibromyalgia is one expression of non-specific hypersensitivity disease and should be treated with diet revision as the first and most essential form of therapy. Not everyone agrees with us. The recent marketing a drug directed at fibromyalgia pain has legitimized the diagnosis. If the drug has any benefit, it comes with a high price to purchase and then a cost to you as you endure the side effects. We have prepared an intelligent guide for people with FM who are motivated to experiment, modify their lifestyle and make a sustained effort to improve. Drugs should not be the preferred remedy.The Alpha Nutrition Program can help to resolve Fibromyalgia and related disorders. The program is both a a diagnostic and a treatment procedure. The first Phase of the program is an attempt to clear symptoms. This is home science. You start with the hypothesis that your food intake is causing or contributing to your illness and you do an experiment to find out if it is true.You want to accomplish four important goals at the same time:

Remove all the problems in your existing food supply

Add all the nutrients your body needs

Reintroduce the best, nourishing foods available and establish a new healthier diet

learn how to take better care of yourself

Begin gentle exercise and slowly regain physical fitness.

BackgroundMusculoskeletal and rheumatic complaints account for approximately 15% of the patients seen by primary care physicians. These complaints include muscle pain and weakness, regional pain syndromes such as back or neck pain, rheumatoid arthritis, and gout. More aggressive pain associated with joint and muscle inflammation is less common and occurs in patients with the autoimmune disorders, ankylosing spondylitis, lupus erythematosus, polymyalgia rheumatica and polymyositis. Marcus stated: "We need to recognize that pain is an epidemic of sorts and that we are not adequately handling patients with pain." He estimated that headaches disrupt productivity in 40-million Americans each year, while back pain interferes with work in 36-million people, muscle pain affects 24-million people and neck pain affects 20-million people. For persistent pain in general, the cost estimates are around $100 billion per year. For back pain in particular, estimates are $16-20 billion per year. He stated: "Back pain is often a problem of fitness…if we made weight loss and exercise a national priority, the result would be tremendous savings for our beleaguered health care system…Even something as simple as walking the equivalent of two miles per day could reduce utilization and cost of medical services.

Obscurity to Big Pharma

Fibromyalgia and chronic fatigue have evolved from relative obscurity to become a brand name for a bizarre assortment of products and services. Drugs are prescribed by physicians in a haphazard manner as if they were browsing through the pharmacy shelf picking out drugs at random. A variety of pain relief clinics offer another random assortment of services. A variety of imaginative explanations is offered with little evidence. Sick lifestyles and environment problems are generally ignored. Drug prescriptions include pain relievers, muscle relaxants, antidepressants, anti-anxiety drugs, sleeping pills and anticonvulsants.

WebMD in 2016 offered this orthodox medical perspective:” Your fibromyalgia specialist may prescribe pain medication or antidepressants to help treat the pain, fatigue, depression, and anxiety that comes with the disease. In addition, your doctor may recommend physical therapy, moist heat, regular aerobic exercise, relaxation, and stress reduction to help you self-manage your symptoms. There is no one "pill" that treats or cures fibromyalgia. A multidisciplinary approach that uses both medication and alternative or lifestyle strategies seems to work best to treat fibromyalgia symptoms.”

Lyrica and Other Useless Drugs

Big Pharma has moved the marketing of Fibromyalgia into big-money TV advertising. The US FDA approved the drug, Lyrica (Pregabalin), for fibromyalgia and TV ads show happy patients enjoying a pain-free life. This is a serious anticonvulsant drug with alarming negative effects including suicide. Lyrica can cause life-threatening, allergic reactions. Symptoms of an allergic reaction include swelling of the face, mouth, lips, gums, tongue, throat or neck. Lyrica may cause depression, anxiety, restlessness, trouble sleeping, panic attacks, anger, irritability, agitation, aggression, dangerous impulses or violence, or extreme increases in activity or talking. Our questions are why would any physician prescribe and why would any patient take this potentially dangerous drug?

Friday, August 05, 2016

Bad Chemicals= Social Chaos Common effects of erratic brain function are conflict and chaos. Two people living together with erratic brain function increase chaos by more than a factor of two. More people interacting erratically increase chaos exponentially until family structures, community structures, and national structures become dysfunctional.Bad chemicals entering human brains from polluted air and water, wrong foods, alcoholic beverages, legal and illegal drugs is a recipe for a society's dysphoric disintegration. We might better appreciate the folly of "fighting a drug war" when we realize that most chemical demons live at home. Unfortunately, in terms of substances that can impair brain function, drug sellers include every corner store, fast food outlet, pop vendor, pharmacy and supermarket. Local bars and liquor outlets generate a continuous stream of social and health problems at an enormous cost to society. We must be smart enough to see the connections among food materials which influence brain function: alcoholic beverages, nicotine in tobacco, teas, coffee, chocolate, spices, food additives, sugar excess, wheat, milk, eggs, prescription drugs and street drugs. We should be very concerned about the prescription drug problem with drug addiction and dependency that is supported by all our institutions. Unfortunately, the practice of medicine has become a drug-pushing affair. An addicted society will better tolerate the social pathology and diseases caused by tobacco smoke, alcoholic beverages, air pollution, bad food, sedatives, antidepressants, tranquilizers, and sleeping pills but displaces its dysphoric energy in a "drug war" against cocaine, heroin and a few other "drugs of abuse". Humans are seldom consistent in setting goals and priorities so that societal confusion about the use and abuse of food chemicals and drugs is more or less predictable. Smart policy makers will, however, understand that most citizens are under the influence of one mid-altering drug or another. The daily use and abuse of several brain chemicals produces mentally disabled people who are neither reasonable nor correct in their thinking and conduct. When physicians intervene and prescribe more chemicals, they add to the chaotic mix, not realizing there is there is little hope of benefit. To my way of thinking, this drug psychotherapy has become a perverse enterprise with no happy endings in sight.From the Human Brain by Stephen Gislason MD

Tuesday, July 26, 2016

Immune Cells

The role of immune networks is to defend the body against foreign invasion. Microbes such as bacteria invade the body and activate innate antibacterial systems, such as the complement cascade. Polymorphonuclear leukocytes are attracted to this activity and attempt to ingest the bacteria.

The surfaces of the body are protected by cells on duty much like a military organization defends a country. The interior body surfaces are lined with a moist mucous-secreting surface that senses and reacts to the ambient environment. Antigens are protein molecules that are recognized by immune cells. Any chemical can link to a protein and become an antigen. Immune sensors or lymphoid tissues are present in the surface linings or mucosa of the intestine and respiratory tract (MALT). These sensors are mast cells, macrophages and mobile lymphocytes of both T and B varieties. B and T-helper lymphocytes can only see antigen presented by macrophages and other antigen-presenting cells (APC). The purpose of the surveillance is to detect and respond to foreign antigens. In the gut, lymphocytes are also contained in follicles, the solitary lymphoid nodules (SLN), found along the length of the intestine and in much of the upper and lower respiratory tracts. SLNs sample the soluble and particulate matter from the environment. The gut-associated lymphoid tissues (GALT) and the lung or bronchus-associated lymphoid tissues (BALT) are sensing agents for the whole body, identifying antigens for later detection by internal immune defenses. Both GALT and BALT and SLNs, contain predominantly B cells in which the major immunoglobulin classes synthesized are IgM and IgA.

Antigen Presenting Cells

Immune responses often begin with macrophages, dendritic cells and other antigen-presenting cells (APC) that ingest process and then present antigens on their surface. The antigen signal attracts other immune cells who recognize it and are activated by it. Antigen is presented adjacent to the major histocompatability complex (MHC) proteins on the surface of APCs. The details of how APCs ingest, digest and then express foreign antigens are being worked out. The antigen moves through the cell membrane and is incorporated into a phagosome which interacts with acts endoplasmic reticulum, a protein transfer system that moves the antigen via a transporter to a location in the cell where the antigen binds to MHC class I molecules. The antigen-MCH complex is then moved thorough the cell membrane to appear on the outside as a receptor. Molecules on bacterial membranes activate toll-like receptors (TLRs) on macrophages and dendritic cells. These cells respond by secreting proinflammatory cytokines as well as proteins such as CD86 and CD40 that activate other cells amplifying the original signals and exciting an inflammatory cascade. Dendritic cells (DCs) discover antigens in peripheral tissues and then migrate to the local lymph nodes, where they encounter CD4+ or CD8+ T cells, which are activated by the presentation of antigen-derived peptides in association with major histocompatibility complex (MHC).DCs take up antigen through different receptor families, such as Fc receptors for antigen-antibody complexes, C-type lectin receptors (CLRs) for glycoproteins, and pattern recognition receptors, such as Toll-like receptors (TLRs), for microbial antigens. Geijtenbeek et al suggested that:” DCs are continuously sampling and presenting self- and harmless environmental proteins to silence immune activation. Uptake of self-components in the intestine and airways are good examples of sites where continuous presentation of self- and foreign antigens occurs without immune activation. In contrast, efficient antigen-specific immune activation occurs upon encounter of DCs with nonself-pathogens. Recognition of pathogens by DCs triggers specific receptors such as TLRs that result in DC maturation and subsequently immune activation. Here we discuss the concept that cross talk between TLRs and CLRs, differentially expressed by subsets of DCs, accounts for the different pathways to peripheral tolerance, such as deletion and suppression, and immune activation.” Monocytes are circulating macrophages that can enter tissue spaces and promote inflammation. Macrophages are found within the endothelium generally and are concentrated in the lung, liver and spleen where they remove antigen and immune complexes from the blood. Some tissues have resident macrophages such as the Langerhan's cells in the skin. Killer T-cells recognize antigen presented on MHC class I on all types of somatic cells. The purpose of the surveillance is to detect, and respond to foreign antigens. Since most antigens are proteins and foreign proteins arrive daily in the food ingested, I am interested in the mechanisms by which food proteins activate immune cells and cause disease.APCs can ingest foreign protein and process them into peptides in proteasomes. Peptides are then transported into the endoplasmic reticulum to MHC class I molecules for presentation. Houde et al, for example, showed that latex beads labelled with fluorescent ovalbumin (egg white protein) were ingested and fluorescence could be detected in the cytoplasm, indicating that proteins are moved from outside into the cyoplasm for degradation by proteasomes. They showed that phagosomes are a site of loading onto MHC class I molecules on the cell surface, leading to T-cell stimulation.

Lymphocytes

Two major groups of lymphocytes are recognized as Thymus dependent or T-lymphocytes; and Bursa dependent or B-lymphocytes. Adaptive immune responses require B cells to provide antibody and T cells to provide cell-mediated immunity. Cell surface receptors recognize antigens. B-lymphocytes learn make antibodies to specific antigens. Although T and B cells share a common progenitor, their development occurs in different locations in the body. B cells develop in the bone marrow and mature in lymphoid tissue. T lymphocyte progenitors leave the bone narrow and travel to the thymus where they mature. The identity of a foreign molecule, microorganism or cell, is recognized by an antigenic determinant, an amino acid sequence, usually contained in an intact protein. Once an antigenic determinant is recognized, its sequence is remembered by clones of antigen-specific B and T-memory cells which can activate other B lymphocytes that make antibodies against the antigen. T memory cells are also referred to a as helper T cells which are activated by the binding of a specific antigen encountered in the past, a signal that initiates defense against familiar pathogens.One of the growing complexities in immunology is the description of cell surface receptors for a growing list of cytokines. Research reports are dense with acronyms, abbreviations and codes that may deter even an experienced reader. Some of these markers are described as CD followed by a number; CD122, for example is a receptor for interleukin 2- . In addition some descriptions emphasize the presence or absence of a well-studied receptor; CD122 + or -. CD receptors may be associated with other surface molecules in complexes. For example, natural killer T lymphocytes (NKT) have CD94-NKG2 complexes that bind to major histocompatibility complex (MHC) class Ib, aka Qa-1, on the surface of antigen presenting cells. CD8+ suppressor T cells regulate peripheral immune responses. The frequencies of blood lymphocyte subsets are monitored by flow cytometry using monoclonal antibodies to identify subtypes: for example, OKT4 identifies CD4+, T-helper cells and OKT8 identifies CD8+, T-suppressor cells.

Virus-specific CD8 and CD4 T lymphocytes play an important role in controlling HIV replication; however CD4 and CD8 lymphocytes are infected by HIV virus. Identifying and counting CD4 cells is a major tool in following patients with AIDs taking antiretroviral medications.

Thursday, July 21, 2016

Food Allergy

The problem is not that 25% of people recognize symptoms from food ingestion, but that many more people do not recognize that food is making them ill. We hope the reader will take the time to find out why we think food allergy is such an important mechanism of disease and how to resolve common food-related health problems by diet revision. Food allergy, as a topic in medicine, has been suppressed for many years and is not taught in medical schools. Too many vested interests have much to lose if more people discovered that popular foods were making them ill. Commonly quoted "expert" opinions tend to minimize the incidence and importance of food allergy. While the dogma is misleading, it represents vested interests and is remarkably persistent.

The conviction that food allergy is a ubiquitous cause of disease comes from knowing the benefits of careful diet revision in medical practice. In response to allergy lobby groups in the USA, the US Congress passed a bill that requires notice on the labels of foodstuffs that contain eight of the most common food allergens. The Food Allergen Labeling and Consumer Protection Act, will require plain English labeling beginning in 2006 of products containing wheat, milk, soy, peanuts, tree nuts, fish, shellfish, or eggs. The bill also requires the Food and Drug Administration to develop a definition of the term "gluten-free" to help those with celiac disease and who require a gluten free diet for other reasons.

The concept of immune responses to food antigens is useful in understanding many diseases. Many of the major unsolved disease of our civilization are either degenerative and/or inflammatory and many are recognized to be inflammatory, immune-mediated, hypersensitivity diseases. In this book, a general theory of hypersensitivity disease as a continuum of disease-causing mechanisms is presented. The term "hypersensitivity" refers to immune-mediated processes that lead to disease. As we consider the possible role of food antigens in causing or contributing to immune-mediated diseases, we look for opportunities to help patients with simple and safe therapeutic strategies such as diet revision. The basic phenomena that concern us are:

The food supply is the most abundant and continuous source of antigenic material.

Different types of food allergy

1. The immediate or type 1 food allergy pattern is easily recognized because it involves quick and dramatic symptoms. Hay fever is the most common type 1 allergy and can be diagnosed by allergy skin tests. Some food allergy is also type 1 and shows up on skin tests.

2. Delayed patterns of food allergy are not so obvious and generally go unrecognized. Allergy skin tests do not show this problem nor do IgE antibody tests. Symptom onset is delayed many hours after eating foods and chronic disease is often the result. Rheumatic diseases, autoimmune diseases, multiple sclerosis, insulin-dependent diabetes, thyroiditis, psoriasis are examples of hypersensitivity diseases that involve humoral and cell-mediated immunity. The common specific problems that are related to food allergy include asthma, rhinitis, atopic dermatitis, urticaria, anaphylaxis, angioedema, allergic gastroenteropathy, and allergic arthritis.

Many patients will express several of these hypersensitivity phenomena over a lifetime and demonstrate an underlying tendency to be hypersensitive. An important concern is the possibility that the chemical soup created by our civilization drives increasing numbers of individuals into hypersensitivity illness. The advocates of a broad definition of food allergy run the risk of being evangelical.

At Alpha Nutrition, a major commitment is to educate people about delayed patterns of food allergy and to point to opportunities people have to resolve serious illness on their own. Our strategies of self-management are simple and straight forward, but require knowledge, perspective and self control. We are the first to acknowledge that some people lack these prerequisites and our information will not help them.

Dr. Gislason stated: "I began to learn about food allergy in 1981 when I first developed inflammatory arthritis. I discovered a simple truth that eating a few safe foods resolved my illness and returning to my previously normal diet recreated the illness that was so severe, I could not work or enjoy life. I thought that my medical colleagues would be as excited as I was to discover that such a serious illness could be cured with diet revision. I did encounter the occasional MD who shared my enthusiasm for further research but most MDs were hostile to the science of food allergy, even when the therapies they offered patients were ineffective and even harmful. I have learned a lot about the politics of medicine and the strategies used by corporations to control the market place. Corporate control has advanced remarkably since I began my quest to understand the mechanisms of food allergy and to teach self-management solutions. Drug companies own medical practice and compete for their market share with skill, determination and huge promotional budgets. They do not want people to solve health problems on their own. They want people to depend on MDs and buy dru
gs "

Inflammation in Vascular Disease

The mechanisms of arterial disease appear to be multiple. Hollander of Boston University suggested that atherosclerosis was an autoimmune disorder with immune complexes injuring blood vessel walls. We think that circulating immune complexes often contain food proteins as antigens and this mechanism is important in causing a wide spectrum of food allergic disease. Since proteins derived from meat, milk, eggs and wheat have the highest risk of appearing in the blood as immune complexes, these foods are reduced or eliminated in the Alpha Nutrition Program.
We ask a simple question - If there is any possibility that chronic symptoms such as attacks of migraine, heart rhythm abnormalities, digestive disturbances, breathing difficulties or brain dysfunction are linked to food ingestion, would it not be prudent to investigate and remove food -causes using diet revision as an inexpensive, safe, effective strategy?

A non-specific indicator of inflammation is the C-reactive protein levels in the blood. Elevated levels are associated with increased risk of heart attacks and strokes. For example, Ridker et al studied 27,939 apparently healthy American women, who were followed for eight years for the occurrence of myocardial infarction, ischemic stroke, coronary revascularization, or death from cardiovascular causes. Elevated C-reactive protein levels were a better predictor of vascular events than low LDL cholesterol levels. The researchers reported that: ” 77 percent of all events occurred among women with LDL cholesterol levels below 160 mg per deciliter (4.14 mmol per liter), and 46 percent occurred among those with LDL cholesterol levels below 130 mg per deciliter (3.36 mmol per liter)… C-reactive protein and LDL cholesterol measurements tended to identify different high-risk groups, screening for both biologic markers provided better prognostic information than screening for either alone.”

Myeloperoxidase is another serum marker of inflammation that may be informative. Myeloperoxidase is an enzyme that generates reactive oxygen species, is released from white blood cells. In one study, plasma myeloperoxidase levels were predictive of subsequent coronary events in patients with chest pain. Myeloperoxidase levels, in contrast to troponin T, creatine kinase MB isoform, and C-reactive protein levels, identified patients at risk for cardiac events in the absence of myocardial necrosis.“

Inflammation can be treated by removing the causes of inflammation, treating infection and using anti-inflammatory medication such as ASA and Statins. The role of food proteins and immune complexes as agents of inflammation is rarely investigated and may turn out to be the hidden agent behind many heart attacks and strokes. Several studies are investigating a variety of immune-modulating therapies to prevent heart attacks and strokes.

Fibromyalgia

Obscurity to Big Pharma

Fibromyalgia and the chronic fatigue syndrome have evolved from relative obscurity to become a brand name for a bizarre assortment of products and services. Drugs are prescribed by physicians in a haphazard manner as if they were browsing through the pharmacy shelf picking out drugs at random. A variety of pain relief clinics offer another random assortment of services. A variety of imaginative explanations is offered with little evidence. Sick lifestyles and environment problems are generally ignored. Drug prescriptions include pain relievers, muscle relaxants, antidepressants, anti-anxiety drugs, sleeping pills and anticonvulsants.

WebMD in 2016 offered this perspective:” Your fibromyalgia specialist may prescribe pain medication or antidepressants to help treat the pain, fatigue, depression, and anxiety that comes with the disease. In addition, your doctor may recommend physical therapy, moist heat, regular aerobic exercise, relaxation, and stress reduction to help you self-manage your symptoms. There is no one "pill" that treats or cures fibromyalgia. A multidisciplinary approach that uses both medication and alternative or lifestyle strategies seems to work best to treat fibromyalgia symptoms.”

Our questions are why would any physician prescribe and why would any patient take this potentially dangerous drug??

Our view is that the Chronic Fatigue Syndrome (CFS) , Fibromyalgia and related disorders are not discrete diseases in the usual sense, but patterns of maladaptive responses to food and the environment. We believe that chronic fatigue syndrome is an expression of non-specific hypersensitivity disease and should be treated with diet revision as the first and most essential form of therapy.

The Alpha Nutrition Program is designed to improve fibromyalgia, chronic fatigue and related disorders. The most definitive clearing program is a food holiday, using an elemental nutrient formula (Alpha ENF), composed of nutrients in their pure form with no other food intake. Alpha ENF allows a sick person to return to a baseline of normal functioning, without the intake of numerous adverse substances that may have been present in their food supply.

Sunday, October 18, 2015

The Combustion Process

Gasoline and diesel fuels are mixtures of hydrocarbons (made of hydrogen, oxygen and carbon atoms.) Hydrocarbons are burned by combining with oxygen. Nitrogen and sulphur atoms are also present and combine with oxygen when burned to produce gases. Attempts to reduce exhaust emissions from gasoline and diesel engines have been compromised by limitations of testing, inherent flaws in the design and inadequate maintenance of emission control devices.

Diesel engines a pose different emission control problems than gasoline engines. Diesels require more sophisticated and expensive components than the catalytic converters fitted to gasoline engines. Diesel emissions contain nitrogen oxide gases and carbon particles, the smallest of which contribute to lung and heart disease. Increases in airborne fine particulate matter increases the risk for myocardial infarctions, strokes and heart failure. Particle deposition in the lungs activates the sympathetic nervous system and triggers the release of systemic pro-inflammatory responses.

Brook and Rajagopalanb stated: "Higher circulating levels of inflammatory cytokines cause vascular endothelial dysfunction and activation of vasoconstrictive pathways while blunting vasodilator capacity. At the molecular level, the generation of oxidative stress with the consequent up-regulation of redox sensitive pathways appears to be a common mechanism of these pro-hypertensive responses. Due to the ubiquitous, continuous and often involuntary nature of exposure, airborne fine particles may be an important and under-appreciated worldwide environmental risk factor for increased arterial BP.

In Sept. 2015 a scandal erupted when Volkswagen, the world's largest car manufacturer, was caught cheating on emission tests of their diesel engines. In testing lab conditions, VW could show conformity with emission standards fro nitrogen oxides. Subsequent independent testing of VW diesel vehicles in road tests revealed high levels of nitrogen oxides emitted in real operating conditions. Errors in media reports proliferated with talk of defeat devices and software that would fool emission tests.

Relevant engineering data was not readily available but likely the cause of the problem was the Nitrogen Oxide converter (aka NOx storage catalytic converter ) that required injections of unburned fuel to keep the converter clean and functional. The exhaust output was supposed be free of nitrogen oxides. The computer that controlled fuel injection was programmed to inject more fuel than was needed for combustion for about 2 seconds per minute. The fuel reaching the converter would burn increasing the temperature in the converter. Burning the diesel fuel in the converter would likely increase the emission of other air pollutants. The software functioned optimally for emissions testing and was turned off when the engine was in service. The NO converter was a poor design that would increase fuel consumption and decrease engine performance if the converter was operated for full emissions control.

Jack Baruth advocated the end of diesel cars and pickup trucks. He stated: "Western democracies encouraged diesel even though they were perfectly aware of the health hazards posed by diesel particulate exhaust. Those risks are far better documented than even the most "settled" climate science, and they are very real. Eurocrats chose diesel in order to be seen to be doing something about global warming, and the manufacturers had to abide by their choice. The result? Paris has had to ban cars for hours or even days at a time because of smog. According to The Guardian, "diesel-related health problems cost (the British National Health Service) more than 10 times as much as comparable problems caused by petrol fumes. Last year the UN's World Health Organization declared that diesel exhaust caused cancer and was comparable in its effects to secondary cigarette smoking. And that was when people thought that these diesels were meeting pollution standards! Now, of course, we know that many of them were not, and that even the diesel cars that weren't designed to cheat the tests are not performing in the real world the way they do in the test labs. In other words, diesel-powered automobiles are killing people, and in not inconsiderable numbers. The jury is in and the evidence is clear." (Jack Baruth. Road & Track. Oct 2015)

A review in the Science journal, Nature, questioned the relationships between auto manufacturers and regulatory bodies: "Among the questions raised by the scandal that allowed the German car maker Volkswagen to sell 11 million vehicles containing software that cheats emissions tests, many will ask why the regulators failed to notice and halt the practice. The answer is not complicated. Regulated industries exert massive, discreet pressure on regulators such as the US Environmental Protection Agency (EPA), to stop them doing their jobs properly."

To put the VW scam in perspective, the big problems were corporate cheating and deliberate violation of public trust. It appears that this deception will cost VW several billion euros and is an embarrassment for all of Germany. Regulatory agencies have been alerted to their limitations and will be changing testing procedures for all new engines that include monitoring emissions during real driving tests in real driving conditions.

Sunday, August 23, 2015

Blood Circulation to the Brain

The brain is a unique organ in the body. The blood circulation in the brain is more complex, more regulated, and less understood than the circulation in any other tissue. The large arteries carrying blood to the brain are the internal carotids and the vertebral arteries. The condition of these arteries determines how much blood flow is available to the brain. The smaller cerebral (pial) arteries respond to changing demands from blood supply from cerebral tissues. This auto regulation tries to maintain stable cerebral blood flow even with unstable cerebral perfusion pressure. Brain circulation responds in complex ways to a large number of stimuli. Failure of autoregulation may be one of the most common sources of brain dysfunction especially in people with high blood pressure on medications.

Brain activity regulates brain circulation by controlling cardiac output and blood pressure. Emotions, especially anger, are strong events that act on the cardiovascular system; heart rate increases and blood pressure rises, often dramatically. Cognitive tasks increase blood flow and metabolic rate in the regions of the brain that process the task. Changes in localized blood flow are the basis of functional imaging studies that reveal the modules in the brain that are active during task processing.

Blood-brain barrier

Cerebral microvessels have a unique feature, the blood-brain barrier, which protects sensitive brain cells from disturbing elements circulating in the blood. Endothelial cells line blood vessel. Their behavior regulates permeability. In the brain, tight intercellular junctions limit endothelial permeability. A variety of chemical signals to and from endothelia cells control blood vessel transactions with glial cells and neurons. Cerebral vessels have nerves supplies -sympathetic, parasympathetic, and sensory nerve fibers. Gaseous transmitters such as nitric oxide (NO) dilate small blood vessels and participate in the regulation of blood flow.

Syncope (fainting) is an expression of reduced cerebral blood flow. Prolonged standing, emotional arousal, blood pressure drugs, cardiac arrhythmias, and autonomic nervous system failure are common causes of syncope. Blood tends to pool in the legs with prolonged standing. Muscle activity is required to pump venous blood uphill back to the heart. With reduced venous return, cardiac output drops and humans faint. A common symptom, the feeling of lightheadedness is an expression of reduced blood flow to the brain. Since cerebral arterial disease increases with age, decreasing symptoms of limited blood flow become more common such as lightheadedness, fainting, personality changes and deteriorating cognitive ability.

Some of the disturbances will be regional with selectively compromised functions. Other disturbances will be global. The use of medications to reduce blood pressure may have adverse effects because lowering blood pressure can decrease cerebral perfusion in patients with chronic vascular brain pathology; they may develop focal hypoxia and even ischemia in poorly perfused regions of their brain.

Stroke is the leading cause of disability in the U.S. and Canada

Stroke is the leading cause of permanent disability in the U.S. and Canada, second leading cause of dementia and the third leading cause of adult death. Stroke is the third leading cause of death and a major source of disability in the US where 700,000 people have a stroke and 158,000 die from stroke. From 1993 to 2003, the stroke death rate fell 18.5%, but the actual number of stroke deaths declined only 0.7%, according to 2006 statistics.

The main event of a heart attack is the occlusion by a sudden blood clot of one or more blood vessels supplying the heart muscle. A similar occlusion of blood vessels supplying the brain will result in the death of brain tissue or cerebral infarction. Another cause of stroke is hemorrhage from a ruptured blood vessel. Yet another stroke mechanism is the occlusion of a brain artery by a clot that traveled to the brain from another body location, usually the heart; embolism is most likely to occur in people with atrial fibrillation and mechanical heart valves.

Neurologists say doctors and the public should give stroke victims the same urgent treatment given to heart attack victims. The clot-dissolving drug TPA (tissue plasminogen activator), when used in the first three hours after a stroke, can restore blood flow in the brains of some patients. Some hospitals have better tools for dealing with strokes, but require the stroke patient to seek treatment quickly. The message in the media is to act fast on the warning signs of a stroke - stokes are now described as "brain attacks" to encourage the same sense of urgency attributed to heart attacks. Symptoms include weakness or numbness, especially on one side of the body; blurred vision, usually in one eye; slurred speech; dizziness; and explosive headache.

The hope for dramatic rescue of stroke victims with TPA is somewhat tarnished by the impractical requirement of getting the right treatment right away. One major problem is that some strokes are caused by bleeding into the brain and TPA would make this worse. Before getting TPA, patients must be checked to ensure they are not bleeding in the brain. If you were planning to have a stroke, you have to set up an ideal circumstance in order to be rescued. You would have to recognize that you were having a stroke almost immediately; you would have to get to a well-equipped hospital promptly; the emergency room would have to be set up to make the diagnosis promptly, get a high quality CAT scan done and interpreted by an expert and then you would have to satisfy several criteria for treatment - the first is that the CAT scan shows that there is no bleeding associated with the stroke symptoms.

Preventing Strokes

We share the conviction with a growing number of experts in the field that simple, safe home remedies especially diet revision and exercise can substantially reduce this destructive disease and save untold suffering and billions of health-care dollars. Smoking must stop. Diabetes, high blood pressure, and high blood cholesterol must be controlled to prevent stroke and, again, diet revision with weight loss and increased daily exercise can work wonders. Drugs are only required if risk factors are not controlled by changes in diet and lifestyle.

Wednesday, July 15, 2015

Dr Gislason wrote: "Selfcare only works if you have adequate knowledge and effective problem solving strategies. In the best case, you would know enough about your body functions to interpret symptoms as they arise and you would take corrective action. You would develop a good sense of what problems you can manage yourself and you would know when to seek help. You would use all the preventive strategies available to you and would use screening tests to detect early stages of disease. I have written several books on specific diseases with the idea of presenting adequate knowledge and suggesting problem solving strategies."

The Alpha Nutrition Program is a rational plan that requires new learning, discipline and self-control. A basic intention is to do a better job of self-regulating. Self-regulation implies control over behavior. I learned by watching a few thousand people attempt to do this program that people with some measure of self-control were uncommon. I learned that self-discipline was in short supply and that rational plans tended to fail without a lot of support. Since eating is a social activity, changes in eating habits require a social method.

Some exceptional people live well-organized lives with traditional lifestyle eating habits and operate from an internal locus of control that gives them an enviable ability to self-manage. If you have a well-developed center, you have an easier time developing new patterns, once you accept that it is necessary and desirable to change. You can plan an orderly transition from old to new. People with a strong internal locus of control are more skilled at collecting and evaluating information. They accept professional advice as information, not as parental authority. They tend to feel more confident making their own decisions."

Interface with MDs

For many years, we have proposed a collaborative relationship between patient and physician. The growth of medical information in the internet gives every intelligent person access to current information and to a variety of options. Often a patient with a specific disease is better informed than the physician. Carolyn Clancy, director of the US Agency for Healthcare Research and Quality stated: Patients are becoming more involved in decisions about their care. Even though this is a major change to how we (MDs) practice medicine, it will, over time, create a genuine partnership between doctors and patients. We recognize the importance of clear, ongoing communication, including questioning why a particular treatment decision was made. We need to engage our patients in the same way. My agency has developed a new public awareness campaign with the Ad Council to encourage patients to take a more active role in their healthcare.

Tuesday, July 14, 2015

Narcotic drugs have always been associated with addiction;
however, narcotic drugs remain the best agents to relieve pain. Pain management
is the reason people are most likely to seek medical attention. Physicians try
to balance their desire to elevate suffering against concerns that the patient
in pain just wants a drug prescription. Physicians remain constrained by problems
of drug dependence and addiction and are reluctant to prescribe narcotics or
prescribe weak, inferior narcotics such as codeine and demerol.

Weintstein et al polled 386 physicians in
Texas and found that a significant number of physicians had prejudice against
the use of opioid analgesics, displayed lack of knowledge about pain and its
treatment, and had negative views about patients with chronic pain. They
suggested that new educational strategies are needed to improve pain treatment
in medical practice.

The narcotics
that are considered to have the greatest addiction potential include codeine 60
mg, oxycodone, methadone, hydromorphone, demerol (meperidine), fentanyl, and
morphine. The World Health Organization (WHO) suggested a progressive treatment
of pain. For mild pain: aspirin, acetaminophen, nonsteroidal anti-inflammatory
drugs and adjuvants. For moderate pain: mild opioids. For severe pain:
traditional opioids. Physician concerns are justified. Narcotic-dependent
people routinely solicit prescriptions from a number of physicians and become
good at feigning painful conditions. Every primary care physician will have
patients who tend to demand prescriptions for pain relievers and other
psychotropic drugs and will become chronic users, unless the physician
steadfastly resists their demands and limits prescriptions to short term
use.

Prescribed narcotics are always available for sale on the
street. Most originate with doctors who are lenient prescribers. Drug
traffickers have lists of lenient Doctors who write narcotic prescriptions on
demand for a fee.Prescribed narcotics
are always available for sale on the street. For example, about two million
Americans have admitted taking OxyContin (oxycodone) illegitimately. The US
Drug Enforcement Administration reported that it is one of the most abused
prescription drugs. Another narcotic, hydrocodone also has a high potential for
abuse. Hydrocodone, as a narcotic cough medicine, is one of the favorite drugs
sought by recreational users when they visit emergency departments. Both drugs
act on the opioid mu receptor which blocks the transmission of pain in the
spinal cord.

In the USA OxyContin is a $1.5 billion per year product. A report
in the New York times from rural Kentucky ( July 2004) provides a perspective
on narcotic drug use: “Ever since prescription painkillers like OxyContin
became the drugs of choice among dealers and addicts in Appalachia, the days of
small-town pharmacists' dispensing medicines from behind an ordinary counter
have become a quaint memory. Now many pharmacies have turned into virtual
fortresses. Some have bars over the windows. The most sought-after drugs are
stored in vaults. The pharmacists often work behind safety glass, and some have
even armed themselves. Surveillance cameras and alarm systems monitor every
spot. Dan Smoot, chief detective for Operation Unite, an anti-drug task force
said that prescription drugs remained the top problem for police agencies in
the mountains. Mr. Smoot recently led the largest drug raid in Kentucky
history, arresting over 200 people on charges of buying or selling prescription
drugs on the black market.”

The muscle relaxer, carisoprodol (Soma) is another favorite
street drug which contains a metabolite of meprobamate, an old tranquilizer.
Taken with alcohol, Soma produces stupor or "Soma coma." Tramadol
(Ultram) is a pain medication that can produce a mild euphoric state.
Dextromethorphan is a cough suppressant found in many cough syrups, which
produces a euphoric state when taken in large quantities and can produce visual
hallucinations.People who take opioid
analgesics for many days will develop physical dependence and will suffer
withdrawal effects if the drug is discontinued suddenly. Symptoms of withdrawal
include drug cravings, muscle cramps, joint pains, anxiety, nausea and
vomiting. Withdrawal is most intense following IV heroin use and is relatively
milder after taking oral medications.

Fentanyl has become the most potent narcotic with the
greatest danger in the form of sudden death. Gatehouse and Nancy reported on
the tragic rise in Fentanyl deaths in Canada. They described:" Over the
past few months, fentanyl has been making headlines across North America, as
police discover more and more of it on the streets, and overdose deaths surge.
Authorities in Alberta linked the drug to 120 fatalities in 2014, and 50 more
in just the first two months of this year. In British Columbia, it killed
almost 80 people in 2014, and was responsible for a quarter of all drug deaths,
up from just five per cent in 2012. In Ontario, where 625 people died of opioid
overdoses in 2013, fentanyl was involved in 133 of those cases and, each year,
it now kills twice as many people as heroin. First developed by pharmaceutical
trailblazer Paul Janssen in 1959, it was originally used as an anaesthetic
under the brand name Sublimaze. The slow-release transdermal patches for
chronic pain relief were introduced in the mid-1990s. Its dangers have also
long been recognized. There have been a number of scholarly studies about all
the doctors and nurses, especially anaesthesiologists, who have become addicted
to it, and notable victims such as Jay Bennett, the late guitarist for Wilco,
who died of an accidental fentanyl overdose in 2009 after being prescribed the
patch for an old hip injury. And the drug’s illicit analogues—there are at
least a dozen variations—have been killing people on the streets since the late
1970s, most infamously under the name “China White.”

The deeper story of
the drug and its abuse is even more worrying. Police and health workers now
face an unprecedented situation, with a burgeoning street trade in both the
legitimate prescription patches and illicitly manufactured fentanyl—often sold
in pill form and made to look like OxyContin, a far less powerful narcotic. The
drug, also available in liquid and powder form, is increasingly being used to
cut cocaine and heroin, dramatically boosting their potency, often with fatal
consequences. Indeed, fentanyl seems to turning up almost everywhere you look.
And it’s killing both inexperienced newbies and hardened addicts. The illicit
fentanyl that’s currently flooding Canadian markets in pill form has more
benign nicknames: greenies, green beans and green monsters (all references to
its emerald hue). But that doesn’t make it any less deadly. Stamped as
OxyContin, the fentanyl has been retailing for as little as $10 a pill—an
indication of how cheap it is to manufacture, and how easy it is to obtain the
raw material.

The big B.C. investigation in March turned up two industrial pill
presses that were used to make the 29,000 tablets. Two of the 14 people
arrested in associated raids in Alberta and Saskatchewan are “full-patch”
members of the Hells Angels. A third man is the president of an affiliated
motorcycle gang, the Fallen Saints.

Then there’s the other problem: the growing
abuse of the legitimate pharmaceutical version of the drug. Prescriptions for
high-dose painkillers have skyrocketed over the last 15 years. A study by a
group of Ontario researchers, published last fall in Canadian Family
Physician,determined that Canadians are
now the world’s biggest per capita consumers of legal opioids, with more than
30 million high-dose tablets and patches distributed every year. Such
widespread availability of opioids inevitably leads to widespread abuse. A
recent meta-analysis by an American Scientist, published in the journal Pain,
found that the average rate of misuse of prescribed painkillers is around 25
per centand that one in 10 medical
users ends up addicted. In recent years, it was OxyContin that was driving that
trend, because it could easily be crushed and snorted. But, once governments
forced the manufacturer to introduce a tamper-resistant formulation, called
OxyNeo, to the Canadian market in early 2012, the preferred high quickly became
fentanyl.

Dr. Karen Woodall, a toxicologist with the Ontario Centre of Forensic
Sciences in Toronto, regularly testifies as an expert in fentanyl cases. She
first noticed the drug in 2005 in the autopsy files that cross her desk. She
later traced deaths as far back as 2002, mostly via people overdosing after
chewing cut-up bits of patches—a particularly dangerous practice, since there’s
no way to predict the quantity of the drug in each piece. “The big problem with
fentanyl is that a lot of people who aren’t tolerant to the drug are taking it.
And if you’re not tolerant, it’s a lot more likely to cause serious toxicity
and even death,” she says. “It severely depresses breathing and the heart rate.
Combined with alcohol or other drugs that slow the central nervous system, it
becomes even more dangerous. It’s a serious issue, we’re seeing more and more
deaths.”

Sunday, July 05, 2015

The study of immunology has revealed a complexity of immune cell types and prolific interactions that overwhelm even the experts. The emerging description of chemical signaling that occurs among immune cells and between immune cells and all other tissues of the body has become especially complicated. As the collected data become denser, even highly specialized researchers have difficulty visualizing what is actually occurring in a diseased body.

The MD examining a patient, using conventional medical tools, is hopelessly inadequate and does not understand what is really going on. Classifications and names have changed with advancing discoveries. There more than 30 members of the interleukin family, for example, subdivided into families. To make a complex matter simple, they can be sorted into pro-inflammatory and anti-inflammatory groups.

Cell Signals

Cytokines are soluble proteins that regulate immune responses. One idea is that cytokines are short range signals. For example, it was though that production in lymphoid tissues is tightly localized and signaling occurs between conjugate cells. Perona-Wright et al assessed cytokine signaling during infection by measuring in vivo phosphorylation of intracellular signal transducer and activator of transcription (STAT) proteins. They stated: We show that interferon-γ (IFN-γ) and interleukin 4 (IL-4) signaled to the majority of lymphocytes throughout the reactive lymph node and that IL-4 conditioning of naive, bystander cells was sufficient to override opposing T helper type 1 (TH1) polarization. Our results demonstrate that despite localized production, cytokines can permeate a lymph node and modify the majority of cells therein. Cytokine conditioning of bystander cells could provide a mechanism by which chronic worm infections subvert the host response to subsequent infections or vaccination attempts.

Another idea is that cytokines provide long-range signalling and help to organize systemic responses to infection and injury.
The nature series of scientific journals sponsors a data base that by 2006 listed over 3700 signaling proteins that carry messages among cells of the body. Dove described the state of signalling science: “Ask a cell biologist to explain signal transduction, and you are in for a long story. The science of understanding how individual cells sense their environments and respond to stimuli fills library shelves, occupies whole departments of colleges and inspires the careers of thousands of researchers around the world. Even so, the field sometimes seems woefully understaffed.

The advent of whole-genome sequencing and gene-expression profiling revealed what most biologists already suspected: we are just beginning to understand cell signaling. For example, cells rely heavily on surface receptor proteins to communicate with the outside world. Often, signals flows through receptors that are coupled to effector molecules called G proteins. Inside the cell, information flow often entails an enzyme finding a specific target protein and attaching or removing phosphates, lipid groups, or other chemical structures. The modified target commonly goes on to modify other targets and so on through baroque cascades of interactions.”

Scientists have described a bewildering complexity of cytokines and variable cytokine production in different humans. We know that humans are not created equal. One significant inequality lies in the ability to produce cytokines of different types. An individual’s cytokine profile will help to determine the response to antigen challenges, susceptibility to different diseases and the severity of the disease, once contracted. Advances in techniques of identifying ever larger numbers of signaling molecules have produced research papers dense with measurement data, often in a curious limbo, where the ephemeral dynamics of cell interactions are scarcely mentioned and not at all understood.

Sunday, March 29, 2015

The difficulties facing medical students and physicians are diverse and persistent. There is no escape from basic human tendencies. The competitive, critical disputatious nature of humans is amplified in medical institutions, despite a superficial appeal to collegiality. Physicians often face moral dilemmas and must cope with the least pleasant aspects of the human experience, often with little or no support from colleagues.

As most medical care becomes concentrated in large, impersonal institutions, a sense of alienation prevails.
A pamphlet from the Canadian Medical Association for physicians talks about the “impact of stress on physician health and well being.” Canadian physicians are generally unhappy about the increasing demands on their time and energy while resources and rewards are shrinking. In Canada, physicians work in a government under-funded system that survives on budget cuts and rationing services.

The CMA pamphlet begins with a fuzzy statement that could win a prize in the annals of obfuscation: “Stress is part of everyone’s life. A certain level of stress contributes to optimal performance. However, when it is not managed properly, stress can become overwhelming, leading to physical, mental and spiritual difficulties.”

I acknowledge that some readers would be more receptive to this kind of talk than I am. However, I would want them to ask what is really going on here? Physicians get tired, discouraged, frustrated and become angry like all other humans.
Physicians tend to be more tolerant and giving than most other humans, but each person has limited understanding and limited resources. When demand exceeds supply, physicians, like other people, get discouraged, tired and angry. They may feel and act badly in a variety of ways. If we really want to understand the plight of physicians, the first step would be to pledge never to use the word “stress” just as we have pledged never to use the word “psychological” or the word “spiritual.” These are nonsense words that obscure what is really going on.

Dr. Pamela L. Wible wrote about physicians' bullying medical students and each other. Increasing concerns about physician burnout and suicide have surfaced in the US. Medical students suffer bullying and some end their lives. Wiebe stated: "The truth is, doctors are suffering. Surrounded by sickness and death, we watch families wail, shriek, cry while we stand silently—sacred witness to their sorrow—until we're called to the next room for a heart attack, a gunshot wound, a stillborn. Week by week. Year by year. And when do we grieve? Never. Doctors are not allowed to grieve. Today a physician tells me she's been cited for unprofessional conduct. Why? She was seen crying. Her boss told her, "Unless you are dying, crying is unprofessional behavior and not to be tolerated." Doctors are not allowed to cry. So, what do we do with our sadness? We injure ourselves—and each other. When I speak to victims of physician bullying, I explain, "Your instructors are suffering from unprocessed grief—probably victims of bullying themselves. Medicine is an apprenticeship profession. Trained by wounded doctors, they're now wounding you. Your bright eyes, your enthusiasm, your idealism remind them of their loss. Rather than feel their own grief, they lash out at you." (Pamela L. Wible. Physician Bullying: 'Not Allowed to Cry'. Medscape. Feb 20, 2015.)

There are few physicians who would not respond well to expressions of gratitude, respect and tender loving care. Each one needs more time off and an assistant or two to do all the extra chores demanded of them. Physicians spend much of their time caring for others but seldom receive care themselves.
The increasing tendency for hospital and government administrators is to treat physicians with disrespect and to blame them for the high cost of medical care. Physicians confront injury, disease, cruelty, ignorance and anger most days and often miss opportunities to celebrate the joyful, creative aspects of life. A basic imbalance for any human is receiving less than he or she is giving. Physicians become overtired, do not eat well or regularly and often fail to enjoy friendly and affectionate leisure time with family and friends…. our description can go on and on. The more we observe specific details of physicians lives (never using the term “stress”) the more we understand how these humans suffer, make mistakes, become dysfunctional and ill or, if they are smart, take a long vacation or quit medicine before they collapse from frustration, disillusionment and fatigue.

Monday, March 02, 2015

Humans like to become intoxicated. Fermented, liquid foods that contain
alcohol are used worldwide in parties, celebrations and rituals. It is common
for fermented foods to be included in the daily diet. Small doses of fermented
foods relax inhibitions and can feel pleasant in social situations. Larger doses
are toxic to the brain and disable the drinker. The regular abuse of
alcoholic beverages is called "alcoholism. The stigma attached to the term
"alcoholism" remains an obstacle to understanding this common problem.

There is a tendency to deny or to "normalize" excessive drinking. The use of
alcoholic beverages is woven into the fabric of society and excessive use of
alcohol is often considered "normal" Regular ingestion of alcoholic
beverage in excess produces many disease patterns involving every part of the
body. Even “moderate” alcohol abuse distorts the personality, emotions and
intellect of the "social drinker." The cognitive impairments and personality
distortion are a direct consequence of brain dysfunction cause by ethanol and
other chemical pathogens in alcoholic beverages. Alcohol abuse is
considered to be an addiction and some argue about calling alcoholism a
“disease.” The term “addiction” refers both the compulsive aspect of drinking
and also to the harm drinking causes. The drinker harms himself, his family and
the community at large. A reasonable person will notice the harm he or she is
causing and will seek to remedy the problem. An addict ignores the harm and
remains devoted to ingesting alcoholic beverages no matter how much harm is
caused.

Intoxication with alcoholic beverages generates behaviors that are
regrettable and often destructive. Drunk people do much harm to themselves and
others. The main drug effect is exerted by ethanol on the brain. As blood levels
of ethanol increase, more and more brain functions are shut-down, rendering the
intoxicant temporarily demented, with inappropriate behavior, incoordination and
poor judgment. Alcohol intoxication routinely promotes fighting, assaults and
death by accident or murder.

Dr. Gislason states in his preface to the book, Alcohol Problems and
Solutions:

"I have learned that humans generally do things that they should stop doing.
In addition, I have learned that reasonable, rational solutions to human
problems are seldom pursued for very long. Alcohol abuse is one of the common
human aberrations that has an easy, rational solution --- stop drinking. But
drinkers routinely avoid the easy, rational path to health and happiness and
instead pursue a self-destructive course that causes much harm and great human
misery. This is a curious feature of the human mind that requires explanation.

Dr. Sidney Cohen, a drug abuse expert, described alcohol as "the most
dangerous drug on earth." There are a variety of drinking patterns and the range
of injury among alcohol abusers is great. Some are mildly injured and can
recover on their own with the right tools and techniques. Others are critically
injured, need hospitalization and prolonged rehabilitation with custodian
supervision. The challenge to a heavy drinker is not just to stop drinking
for a while, but to stop forever.

Alcoholism is a complex and diverse problem. My book attempts to understand
the problem of alcoholism and points to a comprehensive solution that requires
alcohol abstinence and diet revision along with moral and mental resolve to
restore a sane, sensible way of living. "

Monday, January 05, 2015

The tasks involved in self-management are relatively easy, once you have
learned how to do it. There is more and more help available as the concern about
increasing prevalence and cost of DB2 increases. The American Diabetes
Association published revised Standards of Care for diabetes, emphasizing that
high-quality diabetes care must be individualized to reflect the needs,
interests, and abilities of each patient. The primary goal is to reduce blood
glucose levels to normal. You self-monitor blood glucose levels at home and have
HbA1c monitored very 3 months. The secondary goal is to monitor for and, if
detected, promptly treat any developing complications.

Reducing caloric intake is a key to success

If you follow common arguments about diabetic diets, then all diabetics
should eat a low carbohydrate, low fat, low protein diet. The only way you can
achieve all three goals is to eat a low food diet. Indeed reducing caloric
intake is the key to success. Another key to success is to increase your energy
expenditure by leading a more active life.

The Alpha Nutrition Program is a standard method of diet revision that
proceeds in a simple, logical manner. You eat more vegetables, less fat and
balance your new diet according to the best nutritional ideas. The program
leaves out foods and food products that are higher risk and includes foods that
have protective and beneficial effects.

The Alpha Nutrition approach includes Alpha DMX a specially designed
elemental nutrient formula. We invented Alpha DMX to solve the problem of
nutrient deficiency when you reduce your caloric intake. With 25 grams of
Alpha DMX per day, your nutrient intake reaches recommended daily intakes goals
for all vitamins and minerals even if you eat no food.

The Cardinal Rules of DB2

Eat less, exercise more.

You adjust the food you eat and your activity level to bring glucose
utilization into balance with intake.

You monitor blood glucose frequently at first until you understand what
different foods do in your body.

You use exercise to lower blood glucose if the levels go too high.

If your blood glucose is too high, you can skip meals, take Alpha DMX twice
a day and snack on low calorie foods such as celery, lettuce, apples and carrot
sticks.

The basic problem with proposing diet revision, as therapy is that eating
behaviors are deeply rooted in a psychosocial matrix and are not rationally
determined. Diabetic food management requires rational determination of
eating behaviors and food selection. The social basis of eating patterns often
conflicts with individual needs and opposes the attempts made by an individual
to modify diet as a means of restoring or maintaining health.

The idea of "a diabetic diet" as a fixed set of instructions and a
restricted food list is stubborn and fits with a passive-dependent attitude
- "fix me" A new attitude of approach to diet revision is required especially
when you have a chronic illness. The new attitude is based on
self-responsible, self-monitored and self-directed change. The Alpha Nutrition
Program assumes that you are in charge and you make your own decisions. The
professional role is to support your effort to self-manage and assist you in
trouble-shooting when symptoms recur or when irrational eating behavior is
dominant and you need help complying with the healthy path.

People with diabetes 2 have a food-disease. They have the task of changing
their food choices and managing their diet carefully. This is a difficult task.
We develop a perspective on diabetic management and reveal issues that are not
well understood. We will suggest intelligent strategies for self-management of
diabetes 2. Renewed concerns about the safety of popular drugs that lower blood
sugar should focus attention on non-drug strategies.

Understanding diabetes has become more difficult as more is learned. In all
biology, increasing complexity is revealed by ongoing research. Since glucose is
the principle source of energy for all life, complex systems of glucose
regulation have evolved. Eating behavior is steered towards high sugar foods
that, once eaten, require prompt metabolic responses to utilize and store
glucose for later use. Diabetes 2 involves a complex of disorders that start
with appetite dysregulation and continue through disordered metabolism of
glucose, cholesterol and fatty acids. Diabetes 2 is a progressive disorder.
Early corrective action is highly desirable.

The Supreme Importance of Diet Revision

When you are diagnosed with diabetes 2, do not try to hold on to old habits.
They made you ill. You have to change your food choices. You need to lose weight and exercise; 20 minutes per day of walking and resistance exercises that
makes muscles work will correct many metabolic abnormalities, reducing the
risk and the negative consequences of diabetes.

Standard medical treatment protocols for Diabetes 2 always mention diet
revision and then quickly proceed to drug options. While food control is always
mentioned, the critical, decisive importance of diet revision and exercise is
not emphasized. Diet revision is neglected in favor of drug treatments. Diet
revision means changing your food choices and learning how to self regulate by
adjusting food choices and food amounts.

The odd reasoning in medical practice is that even though eating the wrong
food contributed to or even caused the disease, you can just go to the store and
buy a drug that will excuse you from changing the cause. Although some of the
chemicals for sale at the pharmacy may reduce some consequences of eating too
much of the wrong food, a smart person will get busy and remove the cause of the
disease.

If you follow common arguments about diabetic diets, then all diabetics
should eat a low carbohydrate, low fat, low protein diet. The only way you can
achieve all three goals is to eat a low food diet. Indeed, reducing caloric
intake is the key to success. Another key to success is to increase your
energy expenditure by enjoying a more active life. When you exercise more, your
muscles grown in size and strength and become more metabolically active. No drug
can compete with beneficial changes in metabolism that exercise creates.
Exercise acts on all the key metabolic organs and all the signaling molecules
that control metabolism.

Monday, December 22, 2014

The term "depression" is descriptive and vague. I believe the whole concept of depression is flawed and needs to be revised. "Depression” does not point to one discrete disorder but to a variety of unpleasant experiences common to all humans. When the term “depression” is used without qualification, it is usually misleading. Since antidepressant drugs have become a big business, the promotion of "depression" as an illness, treatable with drugs has become a scandalous enterprise with little or no merit.

Although the term “depression” was an invention of psychiatry the use of the term is pervasive in medicine, the media and in folk psychology. Writers, TV journalist and MD’s alike have been talking about “clinical depression” as if the word “clinical” increased the credibility of this dubious term. The best use of the term “depression’ is to point to someone who is unusually sad, critical and angry; a person who does not enjoy life and withdraws from work, play and close relationships with other humans.

Suppression and Oppression

All humans are involved in competition and negotiation with other humans. If you are losing a competitive struggle, you feel, sad and angry, sometimes with a terrible sense of loss; you want to withdraw, hide, cry and sometimes you want to die. If you habitually lose competitions or have an effective oppressor close by, you feel dysphoric often or always. We call this social inhibition, oppression or suppression rather than depression.

The symptoms are features of a withdrawal-inhibition-supplication response that occurs normally in social mammals to reduce the consequences of power struggles for dominance in a social hierarchy. Subordinate individuals in any primate group are more or less “depressed.” They have to withdraw when challenged by superior animals, supplicate and inhibit their self-serving, aggressive inclinations. All humans experience episodes of withdrawal with inhibition and supplication if someone threatens or is mean or if privileges, property or prestige are lost. Whole groups of humans experience collective depression when the group is threatened or diminished in some way. Suicide is equated with depression, but self-inflicted death is a deep and troubling human behavior that cannot be explained away as an illness. Self-inflicted death may follow loss of prestige and property and is associated either with giving up hope of desired rewards, or anger at the inequities and injustices of the “system”.

A reasonable person will acknowledge that life is difficult and suffering is inevitable. Everything we value is impermanent. Every feature of each of us is in flux and we change continuously. We age. We become ill. We suffer injury and loss. No human knows what comes next so that uncertainty is a constant companion. Modern life in cities is not normal for humans who emerged from living in small groups in natural environments and whose basic tendencies want to continue in that style of living, but cannot.

Psychiatrist, Clements observes that normal feelings and the inevitable sadness of life are often denied and turned into a disease that can be treated with expensive chemicals. She stated: “Sorrow is not recognized as part of the human condition and reactive sadness is viewed as a medical illness, a pathology rather than a normal and very human response… I confess I cry for humanity, and another person's tears tend to generate tears in my eyes too. If sorrow can be avoided, well and good. But the reality is sorrow is an integral part of the complicated system of the cosmos, and of human existence.
Depression, a vague label, what is the correct diagnosis ?
Depression as a medical diagnosis is equated with “mood disorder’ and as a problem located inside one individual. Much of the content that is included under the term “depression” has little or nothing to do with mood and involves changes in body function, cognitive dysfunction and changes in specific behaviors. The main textbook features of “depression” are withdrawal from and loss the loss of interest in job, family, social activities and personal hobbies. "Depressed thinking" is said to be pessimistic, critical of others and oneself and tends toward guilty ruminations and suicidal thoughts.

Research into the neurobiology of “depression’ has produced a bewildering display of abnormalities, not because depression is a real illness with a lot of abnormal findings, but because people gathered together under this diagnosis are a heterogeneous group with many contributing disorders. Some are just sad, lonely people with poor diets, poor living conditions, family conflict, no fun and no exercise.

It should be obvious that some people are happier than others and some people live under a cloud of doom. The reader needs to recall our basic understanding of genetics. The idea is that all human characteristics are distributed and, no matter what human feature you are considering, you will find some individuals with more and some with less. When you accumulate sufficient data and do the appropriate statistics, you will have an idea about the distribution of the feature and an indirect understanding of the genetic and environmental determinants of that feature. When researchers reported that variations in a gene they were studying more or less correlated with the tendency to become depressed, the media ran cover page stories linking the gene to “stress” to depression and promising new tests and treatments.

Helen Person in her review of the study stated: “The gene, which encodes a protein called 5-HTT, reveals its influence when people experience divorce, debt, unemployment or other occasions of "threat, loss, humiliation or defeat. People carrying two short forms of the 5-HTT gene had a 43% chance of becoming clinically depressed after four or more stressful events experienced between the ages of 21 and 26. This compares with 17% of those with two long ones… The new results also raise the prospect of genetic tests to predict those who are vulnerable to depression. But this remains unlikely, partly because there is no clear preventative therapy for those at risk. Such a test would also be unreliable. Of the two-thirds of the general population with one or two short stress-sensitive genes, only a fraction becomes depressed. Many other genes and experiences, such as physical illness, are involved. These must be identified before an accurate risk assessment can be made.”

Depression Solution

Many of the symptoms included under the title of “depression” are typical of common food-related diseases including diabetes, atherosclerosis, malnutrition, hormonal dysfunction and delayed pattern food allergy. All these problems require diet revision. We suggest that a prudent person suffering depression and body symptoms would be wise to pursue vigorous, thorough diet revision at the earliest opportunity. Because some brain dysfunction compromises judgment learning and motivation, family members, friends and professional advisors often have to provide the right direction and support.

Celiac disease is the best studied form of delayed pattern food allergy caused
by eating wheat and other cereal grains. A surprising range of disease is triggered
by the proteins in these foods, collectively referred to as gluten. Celiac disease
may present as a vague illness, even a mental illness.

Patients often complain of dysphoria with fatigue, difficulty in concentration,
loss of recent memory, irritability, loss of pleasure and interests, often with
sleep disturbances. Sleep and dreaming are influenced by food problems. Most people
eat their major meal in the evening and snack at night. This food is digested and
absorbed during the night and symptoms often emerge as you sleep. Some allergenic
effects tend to peak at night - asthma, migraine, body pains, and itching are often
at their worst. Sleep disturbances include difficulty falling asleep, frequent waking
and nightmares.

Luostarinen et al suggested: It is well known that coeliac disease may be
associated with various neurological manifestations. We have had a high index of
suspicion of coeliac disease during recent years in our neurological clinic. As
a result 10 (7%) out of 144 of our new coeliac patients were detected because of
neurological symptoms. The most common neurological manifestations were
neuropathy, memory impairment and cerebellar ataxia. In these patient groups
screening for coeliac disease with serological antibody tests helps to find
patients who may suffer from this disease.

Wills suggested A number of neurological syndromes have been described in
association with coeliac disease. These include disorders of the central nervous
system encompassing epilepsy, myoclonus, ataxia, internuclear opthalmoplegia,
multifocal leukoencephalopathy and dementia. Most of these associated conditions
show a poor response to gluten restriction. Peripheral neuropathies, of axonal
and demyelinating types, have also been reported and may respond to elimination
of gluten from the diet. The mechanism underlying these processes remains
obscure but may be immunological or related to trace vitamin deficiencies.
Controversially, it has also been claimed that occult coeliac disease accounts
for a substantial proportion of patients with neurological dysfunction of
unknown cause. Some authorities recommend that cryptogenic ataxias and
neuropathies should be routinely screened for the presence of gluten-sensitivity
but this remains contentious and has not been universally accepted.

Gluten and Cerebellar Ataxia

One example of specific brain injury from eating gluten is cerebellar ataxia.
The cerebellum looks after the coordination and smoothing of movements so that problems
here show up as movement disorders. Gluten sensitivity, with or without classical
celiac disease symptoms and intestinal pathology, is a treatable cause of cerebellar
ataxia.

Bushara et al reported: We investigated the prevalence of abnormally high
serum immunoglobulin A (IgA) and IgG anti-gliadin antibody titers and typical
human lymphocyte antigen (HLA) genotypes in 50 patients presenting with
cerebellar ataxia who were tested for molecularly characterized hereditary
ataxias. A high prevalence of gluten sensitivity was found in patients with
sporadic (7/26; 27%) and autosomal dominant (9/24; 37%) ataxias, including
patients with known ataxia. Patients with hereditary ataxia (including
asymptomatic patients with known ataxia genotype) should be considered for
screening for gluten sensitivity and gluten-free diet trials.

Wednesday, December 10, 2014

Children are exposed to major health problems from their food supply. In affluent countries, the children's food supply tends to be the most processed and chemically contrived of any age group. Food manufacturers and vendors advertise their synthetic, processed foods directly to youngsters, and generally succeed in marketing their products. Boxed, canned, and bottled foods, fast foods, snack foods, candies, chocolate bars, burgers, pizzas, and pop all form the food vocabulary of our adolescents and many of our younger children.
Some problems, such as food-borne infection, insufficient food and malnutrition, are painfully obvious in third world countries but also occur closer to home because of poverty, ignorance, and neglect. Other food problems are less obvious and may not be recognized; these include major, pervasive biological disturbances from inappropriate food choices, food excesses, nutrient deficiencies, food allergy, and chemical toxicity from food additives and contaminants. Children of poor families with limited food choices are more obviously at risk of malnutrition but children of more affluent families may also suffer malnutrition in the form of wrong food choices, caloric excess, nutrient disproportion and even vitamin mineral deficiencies when packaged and processed food replaces real food.

Problems with Common Food Rules

For years, official food rules suggest that children eat from the four food groups: milk, eggs, meat, and whole grain cereals as staple foods. Boxed cereal and milk is a common breakfast. The cereal has been nutritionally fortified, and so has the milk; nutrient intake may be satisfactory by nutrient accounting, but what about the impact of the food on the child as a whole?

The Unique Child

In theory, all children should be treated equally, but all children are not created equally. Nourishing food has to interact with each person’s unique metabolism and reactivity. Many things can go wrong. Abnormal food-body interactions change the rules of nutrition. A cheese sandwich may be nourishing to one child and a toxic mix for another. A chocolate bar with peanuts may please one child and send another to the hospital in an ambulance. Daily milk or bread ingestion may be suitable for one child and cause chronic disease in another.
The premise of the Alpha Nutrition Program is that each child will have a best fit of safe, nourishing foods and nutrient supplements that permit a long and healthy life. Your best fit diet is likely to be different from other people’s best fit. Even close relatives will be different.

Two parents with three children should have five different diets to suit the individual needs of each unique individual. The idea of a “normal diet” suitable for the whole family is flawed. A better idea is that a small selection of best foods may serve the needs of the whole family, but beyond this “core diet” individual differences will become all important in the determination of who does well, who does poorly, and who develops a disease.

Biologists understand that the distribution of observable characteristic follow the distribution of genes in an in any given population. A "normal distribution" of any measured characteristic is a bell-shaped curve, with most scores in the middle range and a few at each end, or "tail," of the distribution.
The main idea is that all human characteristics are distributed and, no matter what human feature you are considering, you will find some individuals with more and some with less. When you accumulate sufficient data and do the appropriate statistics, you will have an idea about the distribution of the feature and an indirect understanding of the genetic and environmental determinants of that feature. Food Allergy is Common

During the first year of life, the infant diet is the most powerful determinant of the growth and development of the child and food allergies are the most common health problem. Many studies show that breast feeding is best and that the feeding of solid foods is best delayed 4 to 6 months to reduce the risk of food allergy. Food allergy in infancy is expressed as crying, colic, vomiting, diarrhea, rashes, eczema and cold-like respiratory congestion. Some infants with food allergies become seriously ill and fail to thrive unless their allergy is recognized and corrected. Infants who develop a food allergy in their first year may "outgrow" the first effects but tend to grow into children with more pervasive health, behavior and learning problems unless their diet is properly managed.

We have found that milk and wheat allergy are common in children of all ages, Food allergy causes physical symptoms and also contributes to learning and behavioral problems. A peanut butter and jam sandwich and a carton of milk is a common school lunch, followed by the most common afternoon symptoms - flushing, congestion, fatigue, irritability and the inability to concentrate.
There are many ways for food problems to interfere with a child's normal functioning and to promote disease. We assume that several problems interact in a complex manner to produce the symptoms and dysfunction that we seek to remedy. It is always necessary, therefore, to correct nutritional problems by complete diet revision

About Me

Stephen is a physician, author, musician and composer. He has written 19 books in the Alpha Education Series that provide guides to managing the most common diseases. Revision of many books are available as 2017 editions. The books are ordered at Alpha Online in either print versions or as eBook downloads.

Alpha Education Books

These books developed gradually from Dr. Gislason's lecture notes and other presentations. In
1991 Dr. Gislason wrote "Nutritional Therapy, his survey of the theory and concepts
behind his method of diet revision. In 1993 Nutritional Therapy Vol. 2 was published
as a large format book that emphasized the practical instructions required to successfully
solve health problems with diet revision. In 1998, the Core Program was transformed
into the Alpha Nutrition Program. A series of texts acted as interfaces to the program,
describing specific health concerns and were first published under the banner of
Alpha Nutrition Health Education, abbreviated to Alpha Education in 2008. Dr. Gislason
has continued to revise and expand these books into informative guides to common
medical problems.

Persona Books

Dr. Gislason had an early start in the study of philosophy and neuroscience.
At age 16, he decided his main life task would be to pursue understanding the human
mind. In the intervening years, he studied neuroanatomy, neurotransmitters,
electronics, computer science, neuropsychology and at the same time he studied
Buddhist philosophy and practiced a variety of meditation techniques.

Music

He is the chief performer, arranger and studio engineer at Persona Digital Studio. He started the 2500 Band in 1996 . The Persona Classical Ensemble was formed in 2007 to arrange and record pieces by JS Bach, Amadeus Mozart and other composers in the classical repertoire. His book Sound of Music was published in Jan. 2011 with a 2017 revision now available.

He has written that singing, dancing and playing music are the best expressions of humans. His review of popular music brings him pleasure and inspiration to develop new compositions. He is most attracted to beautiful ballads, modern jazz and lyrical melodies. He studied piano for many years, beginning a at age 5. As a child, he was immersed in classical music. In high school he started to play the trumpet in bands and continues to play trumpet and flugelhorn parts on the keyboard. In the early 70s, he learned electronics, began building synthesizers and experimented with psychoacoustics. His study of neuroscience integrated nicely with his study of electronic sound processing and sound processing in the brain.